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Nocturnal Dissociation -Awake?Asleep?Both?or Neither?
Mark W.Mahowald, M.D.and Carlos H.Schenck, M.D.
The article in this issue of Sleep and
Hypnosis entitled "Characteristics of
Patients with Nocturnal Dissociative
Disorders"by Agargun et al.(1)underscores
the fact that careful study of unusual
nocturnal behaviors will greatly expand
our understanding of complex behaviors
arising from the sleep period.In this series
of 29 patients with dissociative disorders
(DD),over one-fourth were found to have
nocturnal dissociative episodes (NDEs),often
with dangerous or injurious implications
to the patient or others.These NDEs can
perfectly masquerade as other parasomnias,
such as nocturnal seizures,disorders of
arousal,or malingering.The correct
diagnosis in a given case has obvious
therapeutic and forensic implications.
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